One Tough Girl

It took less than 48 hours to perform major surgery and recover well enough to return home, but what a stressful 48 hours it's been, and we're not totally in the clear yet.

We awoke at 4 AM on Tuesday morning to get ready for our trip to Levine Children's Hospital. Dr Brighton was scheduled to perform surgery at 7 AM and we had to get there early to get the girl prepared. Each person involved in the procedure, from CNA monitoring vitals to surgeon, would ask us what Sera was having done. I suppose it was the hospital's way of confirming that there would be no surprises at the end of the day.

According to the nurse at the front desk whose responsibility was to keep us informed of progress, surgery officially began at 7:45. By 10 AM the Syme's procedure of removing the foot at the ankle joint was completed, and an hour later the two leg bones had been fused by adding a pin. At about noon on Tuesday we were brought to the post-op, recovery room to be reunited with our youngest daughter.

We thought sitting in the waiting room waiting to hear how the surgery went was going to be the stressful part. As it turns out, that was nothing; seeing Seraphina as she was coming off the anesthesia proved to be the real stress-point of the day. As she regained consciousness, she immediately began complaining about the cast and/or the leg. At times she would scream bloody murder. Then she would try to flex her ab muscles to sit up despite the design of the cast keeping her from achieving her goal. Then she would cry about not wanting the cast. And on and on. At one point the nurse suggested another pain med at which point I was ready to scream at her to just do her job and figure it out -- how was I supposed to know which drug would be the magic one to relieve Sera of her discomfort? All I knew was that is was pure torture to watch her seething in agony while I was helpless to do anything about it.

After about 45 minutes of agony, the nurse administered a child's dose of valium which returned Sera to a drowsy state and silenced the fits. The nurse said they discouraged meds that put the child to sleep because of the risk of stopped breathing, and dosing her this way required them to keep an oxygen mask at her cheek in case of emergency. Fortunately, Sera did not have any issues. Now that she was sedated, they opted to move her to a permanent room. Once settled in, we were able to meet the nurses that would be checking in on her for the next 24 hours.

Let me pause here to day that we have many friends who are in the nursing field and we are very humbled by what they have to do each day. I admit that it is very easy to be 100% in favor of their career choice when I am home sitting behind the computer, but it was difficult to maintain that opinion whenever Sera's medication began to wear off and the nurses were not on site immediately to attend to her. I apologize for being selfish when it came to keeping Sera comfortable at the cost of other patients on the floor getting adequate attention as well. Thank you to all nurses for dealing with those emotions from every family every day!

I returned home to check in on our other 3 children and then returned with them so that Sera could see them in person. This made her quite happy and although the meds had her sleeping for a portion of the time we were there, she enjoyed chatting with them when she was awake. Unfortunately she was awake when it was time for us to go, and it took a long time to get us out the door so that the other children could get home, eat a late dinner and get to bed.

This is where I have to again remind the reader that my wife is a saint. Though not an early morning person, she was the first to wake up Tuesday morning, she was the primary caregiver all day in the hospital and she was the one spending the night with Sera where it would be virtually impossible to sleep with all the nurses coming by throughout the night to attend to Sera's needs. Meanwhile, after letting the kids serve themselves from an awesome meal that a VP at my company graciously supplied, I had them help clean up and get ready for bed. After watching a show with my oldest son, I was in bed at 10 PM and slept soundly until 7 AM the next morning. I had a nice breakfast and got a little work done before returning to the hospital, all while Angela was there the whole time on very little sleep and still making herself available to every need of Seraphina. The next time you think WE are doing something terrific to adopt a child with a special need, you'll need to amend that to a SHE to be more accurate.

As for Sera, by the time I arrived around noon on Wednesday, she was doing terrific. When the physical therapist came by with a walker, Sera hopped out of bed and quickly adapted to moving around the room with the assistance of the device. We opted to skip the wheelchair rental and instead use a borrowed stroller to serve the same function. We also passed on a special device to allow her to lie down in the car while traveling, instead using the existing captain's chairs in the minivan in a reclined position.

By 3:30 PM on Wednesday, we were packed up and heading home. It took just over 24 hours between having a foot amputated and walking to the car under her own power. You go girl!

It's great to be home. We can begin working towards a more standard schedule and give some much-needed attention to the other kids who did a fantastic job of taking care of themselves whenever both Angela and I were at the hospital. But we're not totally in the clear yet. Sera is still taking medication to handle the pain. You can tell when the drugs are wearing off as she immediately begins complaining about the cast being too tight and the leg hurting. Per doctor's orders, she is on two different medications for pain which are staggered around the clock. There is usually a good amount of stress during the half hour before and after the doses are given. This will also be the first night without nurses to help and I expect Angela will get the lion's share of the caregiving. I will help as I can, but she has the patience I lack when things don't go the way I would hope. Did I mention she's a living saint?

So what's left? Seraphina will remain in the spica cast for 6-8 weeks while the leg heals. We have an appointment with Dr Brighton at the end of March to check on the results and see if the brace is ready to come off. Shortly after brace removal, we will make plans for a week-long trip to FL where we will meet the prosthetist in person for the first time and get Seraphina's new leg complete with mechanical knee. The trip will last 7-10 days. After that, she'll begin learning to ride a bike -- after all, that was the promise that began this whole ordeal.

I would be remiss if I didn't thank ALL the friends, family, co-workers and even strangers who have offered prayers and best wishes during the past few days. As mentioned above, the VP of my company unexpectedly provided a meal for us (I highly recommend the garlic bread at DaVinci's in Davis Lake as long as you LOVE garlic or are scared of vampires -- both are applicable for me). My sister-in-law was adamant about sending a care package arriving tomorrow. My brother knew a nurse on our floor and the nurse during post-op recovery was neighbor's with a workout buddy. Practically everyone has offered to help in any way they can. All of your thoughts and actions are most appreciated. We have been humbled by all the support you have offered. People are amazing in times of crisis.

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Say Goodbye to the Foot

I don't know that anyone is actively following this blog now that we have been home from China for almost two months but a new entry was warranted as we move forward on surgery for Seraphina. For the past couple weeks, she has not been wearing the temporary device she received in China, complaining that it hurt too much to wear it. We are not surprised as it looked painful even when we were overseas.

If anyone thought we might wait for a while before taking action with her congenitally deformed left leg, they'd be wrong. One month after arriving home from China (1/18/16), we had an appointment with a pediatric orthopedic at Levine Children's Hospital. The doctor took x-rays of Sera's foot and then reviewed them with us and recommended a Syme's amputation -- removal of the foot at the ankle joint and then wrapping the "heel skin" around the bottom portion for added durability. Additionally he would straighten the petite femur in-line with the tibia and fuse the two bones together to remove any play in the residual limb.

Based on our own research and talk with parents who have adopted children with similar special needs, we agreed with the diagnosis and began preparations for a surgery date. In the meantime, we reached out again to Prosthetic & Orthotic Associates (POA) in Orlando to get information on what to do post surgery. We spoke with more parents that had used POA and heard of another option for surgery -- the Boyd method -- and asked our doctor about the alternative. He was very helpful, calling us back in the evening to talk at length about the two procedures and why we might choose one over the other. In the end, based on Sera's unique skeletal system, we opted to stick with the original plan.

We also met with a local prosthetist at the request of the surgeon. He felt it would be worth considering the option of having a local source for future needs, and implied that during the first couple of months post-surgery, we would be dealing with him for PT anyway. As it turns out, his contact participates in the same fitness group that I am in. We met with him on January 28 and he took the time to show us the technology and provide a timeline of what to expect as Sera grows. He and Sera hit it off immediately and I think she thought she might be getting her new leg that same day, especially when the prosthetist mentioned customizing the socket with anything Sera liked (e.g. a design on her t-shirt, a picture from the internet) and the option of paintable toe nails!

While we were comfortable with him, we still felt the need to work initially with POA in Orlando. They have been holding out hands ever since we first received a referral for Sera. I am pretty certain we would not have adopted Sera had Stephanie not called me back on Labor Day 2015 and spoken with me for over an hour about her condition. I'm too loyal not to reward that assistance, especially given the glowing references from so many of the families that have used them.

With all that information behind us, surgery is set for TOMORROW -- Tuesday the 16th -- at 7AM. We are told she will be in surgery for about 4 hours and will remain at the hospital for 3-5 days for observation. Once released, we are being told to expect 8-9 weeks for recovery to the point that we can remove the body cast and head for Florida to finally meet the POA staff in person.

Angela plans to stay with Sera most of the time that she is in the hospital while I shuttle back and forth to watch the other 3 kids at home. So many people have offered to help and we are thankful for that as well as all the spiritual support in the form of prayers. Aside from the anxiety of not knowing what to expect over the next several weeks, I think we are as ready as we can be for the adventure.

I may not be able to provide daily updates over the next several days and week, but I'll try to hit the highlights so everyone can remain in the loop. Take care!

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Homeward Bound

(Note: this may be a long entry, but I think it sums up our return home quite nicely. Worth a read if you have 5 minutes to spare.)

Waking up Friday in China was like any other day since arriving just over two weeks ago. Angela and I were up around 5:30, and while Angela hit the shower, I checked email and other online things after fighting with the hotel WiFi and finding a VPN connection that would both connect and give me access to Google services (e.g. email, blog, Android, etc).

By 6:30 we had Sera awake and grumbling about it still being dark outside. Or at least that's what we assumed she was saying -- this whole language barrier thing has upsides (we can just nod like we care when we assume she's complaining) and downsides (no idea when she wants something specific).

We headed downstairs for our last Chinese breakfast. My plan was to eat something light and avoid any "mystery" foods, but when one of the other mom's questioned a roll with something fuzzy on it, I stepped up and offered to try it out. Turns out the fuzzy stuff tasted like salty carpet lint and the sticky white stuff I originally thought was a custard was actually mayonnaise. Nasty -- should have stuck to tea and fruit.

At 7:30 we were on the bus heading for the airport when our guide ("Jason") took a phone call. It was the airline informing him that our flight from Guangzhou to Beijing had been cancelled. Great way to start our journey home. We stood around in the airport while Jason worked with the airline to get us a different flight that would allow us to make it in time to catch our international flight out of Beijing. He was finally able to get us on a earlier flight. Good for making it to Beijing. Bad for requiring us to now rush through the Guangzhou airport to get to the gate on time.

Jason hurried us to the baggage area. Then he told us we needed to hoof it to the terminal. I was carrying two winter coats, a sweater and three carry on backpacks so that Angela could pick up Sera. Angela (who had been telling be to be calm most of the trip) was so flustered that she tried to navigate between a group of Chinese travelers and tripped over a suitcase that was in her blind spot. Down went mama and Sera to the floor, landing flat on Sera's back. She smacked her head on the marble floor and (rightly so) began screaming in pain. The Chinese strangers gathered round her speaking unintelligibly while I caught up to her to help her up. The young boy that was adopted by the family traveling with us had a seizure, likely as a result of the stress of the situation. Jason was trying to get everyone settled, all the while urging us to press on to make our flight in time. Good times.

Once we were back in motion again, we hurried as quickly as we could (while staying together and being more careful) to the right gate. We arrived to a long line waiting to step out on to the tarmac to board a bus that would drive us to the airplane. Apparently our new plane was pulled into service last minute to combine two flights into one. The result was that we were on a double-decker flight holding 750 passengers. It was almost triple the size of the plane we would fly overseas later, and we were boarding it from a set of stairs on the tarmac.

Getting to Beijing was mostly uneventful. We were separated due to the last minute change of plans so while Angela sat with Seraphina, I was sitting with the dad and new son of our travel partners, two rows further up. When we were preparing to land in Beijing, I heard Sera begin wailing. I assumed it was due to the whole seat belt thing we had dealt with on a previous flight, but it turns out she was upset because the flight attendant took her meal before she was done with it. She only calmed down when another mom offered her some Skittles to get her mind off her missed meal. Are we home yet?

In Beijing, we had to get our checked bags and re-check them for the international flight. We tried to go through the transfer area, but were told we would have to wait an hour before they would process our reservations and issue boarding passes. Later we would learn that we could have gone upstairs and checked in at the normal counter and spent our time at the gate with access to food and rest rooms rather that on a seat in the transfer area with none of those "luxuries". On top of that, we thought that the advantage to the transfer area was that we wouldn't have to go back through a security checkpoint. Wrong. Live and learn.

We finally had boarding passes, but we had to get to the right terminal. It was also about this time that Sera decided she had to have water. Of course there was none to be found where we were and we had to get to our next gate. We spent several minutes trying to find the right way to the terminal. When we finally got upstairs, we made the mistake of heading for Terminal 1 instead of 2 (nothing was printed on the pass). 15 minutes later, with a wailing child in Angela's arms and me carrying a ruck's worth of weight in 3 packs, we made it to Terminal 1 only to learn that our flight was in Terminal 2 where we had just come from. Are you kidding me?

We got Sera a bottle of water (you can't safely drink from water fountains in China) while in the wrong terminal. She took a sip -- yes, one *sip*) before adding it to her bag for something extra for me to carry back to Terminal 1. I was ready to go back to bed. Unfortunately we were only 7 hours into a 30 hour day. Back to Terminal 2 we go followed by a return through the security checkpoint.

At long last, we made it to the right gate. I'm pretty sure it was the furthest gate from the ticket counters. With the added trip to Terminal 1, I'd guess we walked about 2 miles. Now to sit and wait for the plane to begin boarding. While waiting, we grabbed deli sandwiches and drinks from a nearby bistro. Things settled down for a bit while Sera was kept entertained by her surrogate big sister (the family traveling with us). It was a nice respite from the frenetic pace we had set for ourselves up to this point.

The time finally came for our 14 hour, overseas flight. We were seated at the rear of the plane and when we finally got Sera settled in her seat, she began complaining for headphones to use with the entertainment screen. We had to wait for the attendant to get us a set while trying to explain that Sera had to wait. Stress. Once she had the ear plugs, we had to tell her the system would not work until we were in the air. Stress. She would keep pressing buttons on the screen until inevitably tapping the one that called the attendant. We would have to un-tap the request...several times. Stress. The ear buds were too big for her ears and wouldn't stay in. She kept bugging us to make it work but there was no good solution. Stress. When we finally rigged a way to use the elastic from the eye mask (for trying to sleep on the plane) to get the buds to sort of work, Sera would twist around to talk to the passenger behind us and they would fall out again. We would repeat the process several times over the next 13 hours. Stress.

Sera managed to sleep for a good portion of the international flight. This required her to lie down across her seat with her head on Angela's lap. That left her legs to lay on me. Apparently it was inconvenient for her to just place her legs on my lap. Instead she had to prop them against my shoulder. Then on my arms. Then in my face. Then tangled in my headphones cord. Then pushed into my side. I tried leaning the opposite direction to avoid some of the abuse, but I had the aisle seat so the other side meant drink carts hitting me in the shoulder or bodies shoving by on their way to the restroom. One heavyset lady passed by several times and never once tried to pass gently, she would just walk straight up the aisle, allowing her wide hips to rub past my head. Oh God, when would we be home?

Thirteen hours is a long time to sit on an airplane. The time is even longer when in coach, unable to sleep, and dealing with a child that doesn't speak your language but is old enough to "have an opinion". I managed to watch 4 movies, eat two meals, and play 3 games of Soduku, and get about 90 minutes of fitful dozing on and off. That left me with about 2 hours of just sitting around thinking about how much fun I was having.

Seraphina did pretty well with the landing. Except that she apparently had had too much to eat and was not feeling well. To her credit, she was able to let us know how bad she felt prior to spewing the contents of her stomach into the sick bag in the seat pocket. The rest of the descent was spent trying to comfort her while she complained (I assume) of the taste in her mouth and the dribble on her chin. Angela managed to get out a wet wipe for the latter, and I convinced the attendant to give us a little water to rinse her mouth out.

Next up was US customs. The line moved pretty well, but there were a lot of people to check through and we had the added issue of handling the adoption paperwork that would grant Sera automatic US citizenship now that she was on US soil. We were guided to a special line for this purpose which was also for the elderly and the handicapped resulting in longer wait times. It was at this point that Sera wanted to get something out of her back pack. I was all for her taking one of the three most-used items from the front pocket, but she wanted in the main compartment. I discouraged that since it typically involved removing all contents to get to the one item she wanted, followed by one of us putting everything back. Not a good time for that fun. Sera wasn't happy about that (shocker) and proceeded to let us know about it. It started as a general whine and progressed into a full-tilt tantrum. This included wailing loudly, wreathing on the floor, kicking off her shoes, and general displeasure for all the security line to hear. I'm pretty sure every eye was on us. Well, on her actually. Except for mine which were focused on the security check point that we had to reach. Several people came forward to try to console her and I'm sure a few of them wondered why I didn't just give in. But I can't bring myself to give in to a spoiled child having a tantrum in public. That would just convince her that her method works. You're on my turf now girl -- life's going to suck until you learn the boundaries.

About 10 minutes into the tirade, the officials must have realized it was in their best interest to fast track up through the system. We were paraded to the front of the line and had several officers working to complete our paperwork. On the other side, I let her have the pack once we were seated at a bench with a few spare minutes. She took out a book, held it to her chest for a minute, dropped it on the floor, and indicated she was ready to move on to the next adventure.

The transfer security checkpoint line was ridiculous in Detroit. We had an hour until our Charlotte flight, and spent 45 minutes waiting in line. During that time, Sera pulled apart the two wires on the headphones causing them to span about 15 feet and constantly getting tangled. Go ahead and start the sainthood paperwork for Angela. I would call it miraculous that she can deal with the agony of repetitively correcting the same problem over and over. She would untangle the cord and wrap it up and hand it back to Sera. Sera would unravel it, drag it across the carpet a few steps and get it tangled up again, then complain that it was messed up. Angela would repeat the process. Sera would repeat the process. And so on. I would have taken the cord and tossed it in the trash and let the girl scream for another half hour. Who knows, maybe we could have fast-tracked the security line too.

Like Beijing, Detroit thought it would be funny to put the connecting flight at the farthest point from where we originally landed. I left Angela to deal with the girl while I took the 100 pounds (how it felt) of useless carry on items to the gate. It was a walk that took about 15 minutes, with the assistance of the moving walkways and continuously weaving in an out of other travelers. When I got to the gate, I unceremoniously dumped the bags and coats on the ground, sweaty and stinky from 26 hours of stressful travel. I enjoyed about 5 minutes of daughter-free time before Angela caught up with Sera in tow. Sera went to her backpack and learned that the water could not pass through the previous checkpoint. Her world was again collapsing because her water bottle was taken from her. Cue the tantrum.

I think that if we had not been in a public setting, I might have had a small tantrum of my own and thrown Sera across the hall. Probably a good thing there were some 500 people all staring at us instead. I picked up the brat rather abruptly which freaked her out enough to stop complaining for a few minutes. I marched her around the terminal looking for a water fountain. I asked a janitor for directions and realized he didn't speak any English. Of course not; what was I expecting in America? I marched on and gratefully came upon a cart at another gate offering free water to its passengers. I asked the employee at the desk if we could take one despite being on a different flight. She said that if it was for "the sweet, adorable girl in my arms" then yes. I'm not sure, but either someone performed a magic trick and swapped the person who I had been carrying, or this woman was wearing some *thick* rose-colored glasses. In either case, I thanked her and gave Sera some water. She took a sip and returned the bottle to her pack. Why I oughta...

As soon as we were on the plane for Charlotte and taxiing away from the gate, Sera needed to use the bathroom. Sorry kid, we have to remain seated until the plane is in the air. Sorry parents, that is not the answer I wanted to hear. Grumpy kid in the seat between us. Whimper. Sniff. Whatever.

I closed my eyes and pretended I was somewhere alone. We were in the first row of Comfort+ seats, right behind first class with immense leg room, and Jack Daniels was in my near future. La, la, la, la. As soon as we could move about the cabin, Angela took Leah to the rest room. The drink cart blocked them from returning to their seats. I'm not sure if it was intentional on Angela's part, but I had most of the trip to Charlotte sans child and with a cocktail in hand. I might make it home in one piece after all. The attendant seemed concerned that my two travel partners were not in their seat most of the flight. I assured him they were most likely safe. I thought about asking for a second cocktail, but thought that might make me look like a bad father.

After roughly 30 hours of travel, we landed in Charlotte. Following a long, slow walk with Sera from the gate, we turned the corner to head for our bags and were greeted by the three families that had been looking after our other kids while we were gone. They were waving sticks with Sera's face on them and holding up a "Welcome Home" sign. There were pictures taken in abundance and lots of conversation about Charlotte current events. The men all took one look at me and gathered that it was a stressful day. There was some consoling as we gathered the bags. Plans were made for getting Angela and Seraphina home directly while my two boys helped with the suitcases. My oldest son and I took the shuttle back to our car for a Sera-free ride home.

Aside from some screaming from the new girl when the dog got too close (Seriously? Our dog is as gentle as they come. Maybe just a slight bit curious about this new addition to the pack.) our return was most welcomed. I had some ice cream and a glass of milk before heading to bed. This 32-hour day was one of the most stressful in a while. It came at the end of a long two weeks in a foreign land dealing with all the frustrations of being out of our element. There were several times I thought I wouldn't make it, and on more than one occasion I told Angela that we were done -- no more adoptions for me.

But it was all worth it.

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Countdown to Departure

It's Thursday afternoon and we are less than 24 hours from returning home. All the official business is done; we receive Seraphina's visa this afternoon and then all that's left is packing and getting a good night's rest. Tomorrow is a long day. It will begin at 6:30 AM China time (13 hours ahead of Charlotte) and continue until 10 PM Friday night in the Charlotte airport. Considering Angela and I typically don't get much sleep on airplanes, we are looking at pillow (hotel) to pillow (home) time of about 32 hours!

Sera has too much stuff. She began packing 24 hours early.

Here's the rough schedule:

• 0530 (Guangzhou) - wake up
• 0630 (Guangzhou) - bags packed and ready to go; breakfast
• 0730 (Guangzhou) - board bus for airport
• 1130 (Guangzhou) - flight to Beijing departs
• 1400 (Beijing) - arrive in Beijing
• 1740 (Beijing) - depart Beijing on international flight
• 1815 (Detroit) - "only" 35 minutes according to clock despite 14 hours in air
• 2000 (Detroit) - depart for Charlotte
• 2150 (Charlotte) - welcome to Charlotte!
• 2400 (Charlotte) - hopefully we are in our own bed by midnight 

We will have the company of another family from our adoption group traveling with us to Detroit. They live in NW Ohio and brought their 10-year old daughter with them for this adoption of a boy. She has been like a surrogate big sister in Leah's absence and will hopefully be a nice diversion for the long flight overseas.

One other interesting note is that Seraphina will officially become a US citizen as soon as we land in Detroit. That is one of the benefits of both parents going to China for the adoption.

That will wrap up another China adoption for the Smiths. One of the first things we will have to address (following a birthday for our oldest son and Christmas) is a visit to the pediatrician to get things moving on the leg. The temporary, artificial leg she received at the orphanage is too small for her foot forcing her to put her foot in on an angle and letting a ugly looking bone spur on the side of her foot rub against the mold. At the very least, she will need a new, temporary solution. But after spending almost two weeks with her, I have come to the conclusion that she will be better off moving forward with the AKA as soon as possible. We'll be sure to let all know how that goes.

一路平安

(yílù píngān -- safe journey)

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6,000+ Words?

Sometimes I just don't have enough material (or interest) to devote an entire post to a specific event while in China. Here are some miscellaneous pictures that didn't make the cut for an individual post, but deserved a little space on the blog anyway. If a picture is worth a thousand words, than this entry should be good for a six thousand or so.

Thorny exterior houses fleshy, white fruit which tastes like a muscadine grape

Sera's favorite breakfast item. Drinkable yogurt. She puts away 3+ per day

1) Nature is everywhere in China, even alongside elevated roads
2) QR codes are everywhere too -- TV commercials, billboards, headrests on bus...

Seraphina made the medical visit look easy. Didn't even shed a tear for the TB shot

Vending machine for liquor! $16 for a fifth of whiskey and no ID check.

Not sure where her new look comes from? Showing off the good leg in public draws stares. We just shrug.

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